Healthcare Provider Details

I. General information

NPI: 1366425829
Provider Name (Legal Business Name): SCOTT J JOYCE CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 MAIN ST
GREENVILLE PA
16125-2608
US

IV. Provider business mailing address

100 SHENANGO AVE
SHARON PA
16146-1503
US

V. Phone/Fax

Practice location:
  • Phone: 724-588-5250
  • Fax: 724-588-5253
Mailing address:
  • Phone: 724-981-2246
  • Fax: 724-981-0553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN504687L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberTP006748C
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP007134
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: